Elevated levels of CA 19-9 and CA 125 in an amoebic cyst mimicking liver cancer

Abstract

Amoebiasis is a widespread parasitic disease, more common in underdeveloped countries, caused by the protozoan Entamoeba histolytica. Patients typically present with acute or chronic abdominal pain and associated constitutional symptoms, but rarely have concurrent dysentery or bloody stools. In most cases, medical management alone is sufficient to treat uncomplicated cases. We describe here our findings and treatment of a patient with an amoebic liver abscess who presented with high levels of CA19-9 and CA 125 in the abscess pus, and was misdiagnosed of liver malignancy. This case report demonstrates the difficulty encountered in the differential diagnosis of inflammatory processes and malignant tumours in the liver. Despite adequate pre-operative imaging and thorough intra-operative examination and given the low suspicion for the disease and clinical mimicry, diagnosis, in such cases, is made by histology.